Result of laboratory tests *In the blood test: RBC — 4.9x10"/} Hs 168 - g/I; WBC - 11.4x10°/t neutroph. - 55, bands ~ 13, eos. - 5, basophil. — 1, lymph. — 22, monocyt. - 4, platelet — 193x10°/t ESR - 28 mm/hour. * Biochemical analysis of blood: total protein - 80.9 g/l, albumin - 49.1 g/l; total bilirubin - 18.8 mmol/l; ALT - 35.1 U/l; AST - 27.2 U/l; GGT - 50 U/l; AP - 75 U/l; creatinine - 85 pmol/l; urea - 5.7 mol/l; alpha- amylase - 270 U/I; glucose - 5.01 mmol/l. cae Pancscl tis Canaval living Anshs ° ‘Gytolis, with inflammatory reposence lukocytoiss with left sided shift(band) Esr increased{bacterial infection) Gates. Go - 19( 99) §[L cuntinina 53-106 Albumin - 35 - 50 9/L - ~ 3.33 - &. Tokel b:Mubin - 2-17 meal te - 3-83 ° ALT - lo-4o v/L Paonia - 2S lis G&OT- 9- 30u(L AP ~ 30-Su/LEsophagogastroduodenoscopwith biopsy + The esophagus is freely passable, the mucosa is pale-pink. The lower esophageal sphyncter’ closes completely. The stomach is freely straightened by air, of the usual sizes and shape. A mucosa is slight! focally hyperemic in the Antrum. Folds of the mucous are of usual configuration, elastic, freely straightened by air. The biopsy by OLGA is taken. Duodenal bulb is of normal configuration, freely Hattened by air, palepink, mucous of retrobulbar part is pink. Urease test +++. * Pathomorphological examination: there is an atop ‘ond degree in the Antrum and an inflammation, of the 2nd degree; at the body of the stomach there is atrophy of the second degree and inflammation of the first degree; at the angle of the stomach there is atrophy of the 2nd degree and inflammation of the 2nd degree. The risk fs low. Type B gastritis, H.pyloriEsophagogastroduodenoscopy * Esophagus is freely passable. The mucous membrane is pale-pink. Zine is located on 39 cm from the incisors. Cardiac sphincter closes. + Stomach: There is a moderate amount of secretion in the lumen. In the area of the corner of the stomach it is determined a zone of infiltration of the mucosa measulng— 30x10 cm, in the its center itéedatecmined apaulcer of ie wrong shape meas 5x1.5 cm (biopsy). The mucous membrane is moderately hyperemic. The foids of the mucous membrane are of the usual configuration, elastic. * Peristalsis is active. The goalkeeper closes. Duodenum: the bulb of the duodenum is’ of normal ‘configuration, mucosa is pale-pink. The major duodenal papilla is of the. usual size, is unchanged. The mucosa of the retrobuibar area of the duodenum is pale-pink. There is unchanged bile in the lumen of the duodenum. * The test for H. pyloriis positive. —— Gastic ulcer due to H.plor. Size 2.5x1.5em big ulcer N otEsophagogastroduodenoscopy Esophagusis freely passable. It’s mucosa in the distal part is hyperemic, swollen with contact bleeding and multiple linear confluent erosions. The socket wer esophage: ‘ter closes incom ‘omach: There is a moderate amount of secretion in the lumen. The mucous membrane is pale-pink, The relief of folds is saved the peristalsis is observed and active. The pylorus is closed. Duodenum: the bulb of the duodenum is of normal configuration, mucosa is pale-pink. The mucosa of the retrobulbar part of the duodenumis pale-pink. GERDAbdominal ultrasound * The liver is not enlarged, right lobe is 139 mm, left lobe is 56 mm in size, the edge of the left lobe is rounded. The contour of the liver is smooth, and its parenchyma is slightly, uniformly hyperechogenic focal changes are not detected The portal vein is not dilated (10 mm in diameter). * The gallbladder was removed. + Common bile duct is located at the level of the liver gate, it is 4 mm in diameter * Pancreas is normal in shape, the contouris clear, smooth and is not enlarged. It is 18 mm at the level of the head, 20 mm at the level of the body and 18 mm at the level of the tail in size. The parenchyma is hyperechogenic, the structure is diffusely heterogenic The main pancreatic duct is not dilated. Homatalnav Common Bile duct, changes seen in chronic pancreatitisResult of laboratory tests The results of biachemical analysis of blood *creatinine- 149 mol/L *urea-9.2 mmol/L *K+-5 mmol/L *Na+- 138 mmol/L *Ca** - 1.99 mmol/L *P-1.65 mmol/L * Calculated GFR = 49 ml/min/1.73n. CKD : 3% stageResult of laboratory test The urine analysis: the amount of urine - 140 mL; color yellow, muddy shade; specific gravity - 1010; glucose - not detected; protein “%-2—g/ep acetone and bile pigments - not detected; microscopic examination of urine sediment: epithelial cells - single; leukocytes - 3-4 in the field of view; erythrocytes - 20-22 in the field of view; cylinders - hyaline and erythrocyte in the field of view; mucus, salts and bacteria were not detected. Protinurai +hematuriatcystals Nephrotic syndrome Hypoalbunemia, hyperlipidemia,Result of laboratory tests The urine analysis: the amount of urine - 100 ml; color- light yellow, transparent; specific gravity - 1008; glucose - not detected; protein - 1.6 g/L; acetone and bile pigments - not detected; microscopic examination of urine sediment: epithelial cells - single, mixed; leukocytes - 35-38 in the field of view, eosinophils are visualized; erythrocytes - 15-20 in the field of view; cylinders - leakoeyte-aremerythroeyte=in the field of view; mucus, salts and bacteria were not detected. lepritics, eosinophils(hypersensitivity) so leukocyte(leukocyte formula is needed if (6 the hypersensitivity neutrophils bacteria)Result of laboratory tests *The urine analysis: amount of urine — 150 mL; color - brown, cloudy hue; specific gravity - 1025; glucose — not found; protein - 2.1 g/L; acetone and bile pigments - not detected; microscopic examination of urine sediment: epithelial cells - single, mixed; leukocytes - 2-3 in the field of view; erythrocytes - 40- 45 in the field of view; cylinders - hyaline and erythrocyte in the field of view; mucus, salts and bacteria were not detected. + Nephritic syndrome glomeruloResult of laboratory tests “Common blood count:_erythrocytes— 3,0#1022/1; jemogiobin ~ TOO/L; platelets ~ 380*10"/L; leukocytes — 60°10°/L; metamytlocytes — 3%, bands — 3%; segmented neutrophils ~ 57%; eosinophils - 4%; basophils — 7%, lymphocytes ~ 24%; monocytes ~ 2%; microcytes - + +} poikilocytes- +, anisochromia- +. ESR- 40 mm/hour. + Biochemistry test: creatinine 109,3 wmol/|; total protein— 0 aft; direct piirubin — 30 umol/t indirect lirubin = 11,0 mol/l; AST — 0,38; ALT ~ 0,54; blood glucose ~ 4,0 mmol/l. Iron deficiency, chronic myeloid leukemiaResult of laboratory tests Complete blood count + hemoglobin — 90 g; * erythrocytes— 3,3¢10"7/L; *Color index 0, * reticulocytes— 1,2%; sleukocytes -_ 4,8¢10°/L: bands — 3%; segmented neutrophils — 70%; eosinophils — 2%; lymphocytes — 25%; monocytes— 10%; + hypochromia Fe DefficiecyBygep oGuera wpner Result of laboratory tests + Complete blood count: erythrocytes ~ 0,8¢102/L; hemoglobin = 29 g/L; Color index ~ 1,4; platelets - 40¢10°/L; leukocytes — 1,3010°/L; bands — 5% segmented neutrophils — 56%; eosinophiis - 3%; lymphocytes — 31%; monocytes ~ 3%; anisocytosis +; poikilocytosis + jormal. * Ova parasite stool test: * Biochemistry test: creatinine — 59,3 mol/L; total protein — 66,3 g/L; direct bilirubin — 1,0 pmol/L; indirect bilirubin — 23,5 mol/L; AST - 1,04; ALT - 0,58; blood glucose — 4,5 mmol/L. B12 lack 5 Abray lcmResult of laboratory tests * Total protein 56 g/L; * Creatinine 55 umol/L; + Total cholesterol 3.8 mmol/L; + Amylase 87 U/L; + Alkaline phosphatase 53 U/L; * Iron 4.6umol/L; + AST 10 U/L; * Glucose 4.1 mmol/L; * Hemoglobin 100 # RBC 3.1x10?/L; WBC 7.9 x 10/L; Platelets 212 x 10/L; Hematocrit 40%; The mean erythrocyte volume is 66f1; ESR 15 mm/hour. + Antibodies to tissue transglutaminase IgG 116.6 U/ml (reference values>7 positive). + Antibodies to tissue transglutaminase IgA 12.2 U/ml (reference values> 7 positive Celiac dieasesResult of laboratory tests i i tient’ “arnt STATON tS mi aces RAOUL Basonhls i, eosinophs aki ieutrophs segment let 1 20%, monocytes7-5 Biochemical analysis of blood * Indicator Level Norm + Glucose 6.7 3.3 5.5 mmol/. mol/L 137 -452 mol /L 110 umol/L $3 “115 umol /L + Greactive protein 32 mg/L <6 mg/L GoutRA Biochemical and immunological analysis of blood: * Indicator Level Norm * Rheumatoid factor 1:16 <1:32 * BP to cyclic citrullinated peptide 98 U/mL <17 U/ mL * C-reactive protein 24 mg/L <6 mg/L